Medical Pharmacology Practice Questions: Congestive Heart Failure

Most common symptom of heart failure:
1. peripheral edema
2. angina
3. pulmonary hypertension
4. dyspnea
Cause (s) of reduced lung compliance in congestive heart failure:
1. vessel enlargement
2. interstitial pulmonary edema
3. both
4. neither
Sudden onset of severe shortness of breath and coughing, awakening the patient:
1. orthopnea
2. paroxysmal (nocturnal) dyspnea
3. cardiac dyspnea
Associated with acute pulmonary edema:
1. reduced pulmonary capillary pressures
2. alveolar edema
3. extreme shortness of breath
4. B & C
5. A, B & C
Characteristics of cardiac cachexia:
1. increased circulating tumor necrosis factor
2. hepatomegaly
3. poor gastrointestinal absorption
4. anorexia
5. all of the above
Concerning digitalis glycosides:removal of glycoside moiety --
1. primarily affects Na/K ATPase binding
2. primarily affects pharmacokinetic behavior
3. affects both
4. affects neither
Primary chemical components of digoxin (Lanoxin, Lanoxicaps):
1. lactone ring
2. steroid nucleus
3. sugar residues
4. A & C
5. A, B & C
Cardiac glycosides: principal mechanism of action --
1. blocks beta-adrenergic receptors
2. activates myocardial leukotrienes
3. inhibits Na/K ATPase
4. inhibits calcium transport
5. increases circulating endothelin I
Electrophysiological effects of digitalis:
1. prolongs effective refractory period
2. shortens effective refractory period
Symptoms of digitalis toxicity:
1. first-degree A-V block
2. nausea
3. disturbed color vision
4. B & C
5. A, B & C
Useful in managing serious ventricular arrhythmias due to digitalis overdosage:
1. potassium administration
2. phenytoin (Dilantin)
3. both
4. neither
Anti-digoxin immunotherapy is an effective antidote for digitalis intoxication
1. true
2. false
Characteristics of first-degree heart block -- a symptom of digitalis overdosage
1. P wave (identical) before each QRS
2. PR interval > 0.2 seconds
3. QRS < 0.12 seconds
4. regular rhythm
5. all of the above
Use of ACE inhibitors improve survival in patients with overt heart failure:
1. true
2. false
Concerning the use of ACE inhibitors in heart disease:
1. benefits due to reduction in circulating angiotensin II levels
2. contraindicated in diabetic patients
3. contraindicated in hypertensive patients with hypertrophic left ventricles
4. reduces efficacy of diuretic treatment requiring higher diuretic dosages
ACE inhibitors are particular use in patients with renovascular hypertension due to bilateral renal artery stenosis
1. true
2. false
Site of action torsemide:
1. proximal tubule
2. distal tubule
3. descending limb -- loop of Henle
4. thick ascending limb -- loop of Henle
Fraction of filtered solute load reabsorbed by thick ascending limb of loop of Henle:
1. five percent
2. ten percent
3. 25 percent
4. fifty percent
5. 90 percent
Utility of loop diuretics and congestive heart failure:
1. rapid increase in venous capacitance
2. rapid and substantial natriuresis
3. both
4. neither